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There are a record number of North American women now entering a new period of their lives, menopause, which marks the official end of their reproductive period. Women are born with a finite number of eggs in their ovaries—by the time they reach their 50s, the number of fertile eggs has dropped significantly. When the remaining eggs are released, or hormones in the body can no longer stimulate their release, the body enters menopause. This generally happens between the ages of 45 and 55, with the average age being around 51.

When a healthy, middle-aged woman has gone 12 months without a menstrual period, she is usually considered to be approaching menopause. There are several different stages that you need to know about. Perimenopause is the transition period into menopause, starting anywhere from two to 10 years before your last period. At this time, the ovaries start producing less estrogen. Postmenopause refers to the years after menopause, when your estrogen levels are lowest.

Some of the symptoms of perimenopause and menopause may include hot flashes, irregular or skipped periods, mood swings, insomnia, fatigue, depression, irritability, headaches, changes in libido, anxiety, weight gain, mental confusion and difficulty concentrating, night sweats, reduced bladder control, and hair loss or thinning. Many women going through menopause are on the hunt for the best solutions to these side effects. Some of the most common questions that usually come up during this period are about how to deal with hot flashes, mood swings, hormones and aging, and about skin care for menopause.

Menopause symptoms will be different for every woman. Interestingly, symptoms can also sometimes vary by culture. Japanese women, for example, report fewer hot flashes, among other symptoms; Thai women tend to have more headaches; Scottish women report fewer severe symptoms; Greek women have a higher rate of hot flashes; and Mayan women report few or no symptoms at all. This could be related to a variety of different factors, including diet, lifestyle, and environment.

If you’re nearing menopause, you may experience some, or perhaps none, of the symptoms. But if you do, here’s how you can manage them.

Keep a glass of water by your bedside. Throw in a couple of ice cubes to keep it cold through the night.

For immediate cooling relief, keep a bucket of ice near your bed with a face towel on top.

Make sure you’re getting enough calcium, magnesium, and vitamin D.

Practice rhythmic breathing and use it when hot flashes strike.

Menopause-related mood swings, depression, and stress management:

Regular sessions of exercise or yoga can get rid of stress and help you get a better night’s sleep.

Massages, meditation, and deep breathing are also effective for ongoing stress. Talk about your concerns with friends, especially women who are going through menopause too. It’s a great way to release tension and learn about how they’re managing their menopause symptoms.

Insomnia:

Herbal supplements, such as valerian and chamomile, have been shown to help with menopause-related insomnia.

Changing hormone levels during menopause can completely alter the physiology of skin—it can become oilier than usual, or drier than usual. So, the skin care products you were using before may not be as effective anymore—it’s important to use the right products for your new skin type.

For oily skin, use a gentle cleanser. Avoid the urge to use a harsh exfoliant.

For dry skin, avoid long showers or baths in scorching hot water, which will make it worse. Use a hydrating moisturizer while skin is damp and more absorbent.